DiversityNursing Blog

6. …but people still expect them to show up the second they ring the call bell.

7. Sometimes they’re working so hard, they can go entire shifts without eating, drinking water, or sitting.

instagram.com

Lunch break? What’s that?

8. Ditto going to the bathroom.

instagram.com

9. Some patients will incessantly hit on them.

Fox / Via nurseeyeroll.tumblr.com

10. Others will expose themselves for no clear medical reason.

Flickr: eflon / Creative Commons / Via Flickr: eflon

“Your arm is broken… so why is your dick out?”

Source: www.buzzfeed.com

By SYDNEY LUPKIN

Seattle Children's Hospital hallways erupted in cheers and applause this weekend as the Seattle Seahawks played a nail-biter of a game against the Green Bay Packers and officially locked down their spot in Super Bowl XLIX.

And 8-year-old Maria Moore's room was no exception. The recovering leukemia patient watched the game while wearing her Seahawks hat and clutching her signed football. On the table next to her, she propped up a photo of herself with Seahawks quarterback Russell Wilson, who visited her at the hospital in November.

At one point, Maria was so bummed that her team appeared to be losing, she shed a little tear, her dad told ABC News. He told her not to worry, that Wilson and the Seahawks would come back. And they did.

"We were just totally shouting and applauding and hollering and giving high fives to each other," Thomas Moore told ABC News. "It was an amazing gave to watch. She was super excited."

Marie was diagnosed with acute lymphoblastic leukemia in September and initially didn't respond to chemotherapy, but the doctors at Seattle Children's and Fred Hutchinson Cancer Research Center helped get her treatment "recipe" just right, he said. Marie underwent a cord blood transplant on Jan. 2, and is in remission, but should be at the hospital a few more weeks, he said.

"We’ll probably be watching [the Super Bowl] from the hospital, but that's OK," he said. "As long as she's doing well, that’s fine by me."

Nearly every Tuesday, the team's star quarterback, Russell Wilson, visits Seattle Children's Hospital to meet with patients, said hospital spokeswoman Kathryn Bluher. So the team holds an extra special place in the hearts of patients and their families.

Wilson visited Maria the day after flying back from an East Coast game in November, and she was "all smiles," Moore said.

"It makes a bigger fan out of me. I really can't say enough," Moore said. "[Wilson] is a down to earth, really nice guy. He takes time talk to the kids, do pictures, sign some things."

After Sunday's win, patients at Seattle Children's Hospital took photos with "Congratulations" signs from their hospital beds to show their support.

"It takes their mind of things," Moore said. "It gives them something fun to think about."

Source: http://abcnews.go.com

Moments after Jacob "Jake" Boddie woke from surgery to remove a tumor in his pelvis, his father, Kyle Boddie, said to his 2-year old son, "Hey, Jake, bust a move!" Although he was still groggy, the toddler smiled. One tiny shoulder, then the other, wiggled in time to a beat. 

Kyle and Jake's mother, Ashley McIntyre, say Jake started dancing long before he could walk. "And now that's all he does," Kyle said. "He loves it. You can't stop him."

During his yearlong treatment for a rare cancer, Jake danced with his nurses, child life specialists and doctors at the University of Chicago Medicine Comer Children's Hospital. He boogied in his hospital room, in the hallways, and even on the way to the operating room. His parents say dance helped Jake recover from his treatments and surgery. It helped them cope with their son's illness. 

"Even though Jake went through so much, he uplifted us," Ashley said. "We thought, if he can have fun through all of this, why can't we?"

Kyle and Ashley knew something was wrong when Jake wasn't acting like himself at a Fourth of July picnic in 2013. Agitated and restless, the toddler wasn't his "silly self" and refused to dance or play with the other children. A few days later he began limping. An ultrasound performed in the emergency room at Comer Children's Hospital showed a large mass resting in the lower part of his abdomen and reaching into his pelvis.

A biopsy revealed the mass to be a sarcoma, a fast-growing cancer. "The tumor was 4 inches in diameter, about the size of a small grapefruit," said pediatric oncologist Navin Pinto, MD, an expert on sarcoma treatment. In addition to his clinical work, Pinto leads a personalized medicine initiative at Comer Children's Hospital that is sequencing the genetic makeup of pediatric tumors from every patient to help guide treatment.

For Jake, several rounds of chemotherapy were needed to shrink the tumor to half its original size. It was then small enough to be removed, but Jake's surgery would be complicated. The tumor was wrapped around critical blood vessels as well as the right ureter, a tube that brings urine from the kidney to the bladder. 

On the morning of the surgery in January 2014, Ashley and Kyle danced with Jake to the song "Happy" as they headed toward the operating room doors; there they turned him over to the surgical team. "Jake knew something was going on," Ashley recalled, "but I think it made him feel better to see us laughing and dancing."

Pediatric urologist Mohan Gundeti, MD, and pediatric surgeon Grace Mak, MD, worked together in the surgical suite. First, Gundeti used an endoscopic approach, placing a stent in the ureter to mark its location and keep the fragile tube open. Mak then surgically removed as much of the tumor as possible, meticulously separating it from the vessels and ureter while avoiding nearby nerves. 

"Jacob recovered beautifully and bounced back quickly after the operation," Mak said, adding, "he was eating -- and doing his moves -- a few days later."

Completing Jake's treatment required both chemotherapy and radiation to eliminate any lingering cancer cells. In addition, the lower section of the right ureter had narrowed, leading to pressure on the right kidney, and needed attention before it became completely obstructed. 

Gundeti performed reconstructive surgery, moving the right kidney down a few centimeters and making a new tube for the ureter using a flap from the bladder. Again, Jake recovered quickly from an extensive surgery.

Today, the 3-year-old visits Comer Children's Hospital regularly for follow-up care with the nurses and doctors who cared for him. 

"He feels comfortable at the hospital; he's always laughing and having a good time," Kyle said. "Everyone knows him now. And everyone dances with him."

Source: www.uchicagokidshospital.org

By Dan Kedmey

General Electric released images on Wednesday from its first clinical trial of a next generation body scanner that captures bones, blood vessels and organs in high-definition.

The patients ride into the chamber of the scanner, dubbed “Revolution CT,” where a fan-shaped beam of x rays passes down their bodies and a computer reconstructs a digital model of the body, slice-by-slice. The scanner can build an image of a heart in the time it takes for a single heartbeat, according to GE.

The snapshots below, provided by GE, may look like an artist’s rendering from an anatomy textbook. In fact, they were taken from living patients at West Kendall Baptist Hospital in south Florida, the first hospital to test the new scanner in the field.

Source: http://time.com

By Carolyn Kylstra

1. They work 10- or 12-hour shifts, often without breaks.

Actually, make that 13 hours.

2. Those 10- or 12-hour shifts? They might just start at 6 am. OR AT 6 PM.

BuzzFeed

Rise and shine!

3. They have no idea what they’re about to encounter literally every time they go to work.

NBC / Via uproxx.com

4. Except they know for sure that they will be doing paperwork. Lots and lots of it.

Pixar / Via youtube.com

5. They’re usually taking care of about six (or more) patients at any given time…

CBS / Via cambio.com

Source: www.buzzfeed.com

U.S. health officials have hard numbers to back up their warnings that this season's flu shots are less than perfect: A new study finds the vaccine reduces your risk of needing medical care because of flu by only 23 percent.

Most years, flu vaccine effectiveness ranges from 10 percent to 60 percent, reported the U.S. Centers for Disease Control and Prevention.

Despite the reduced effectiveness of this season's flu shot, "vaccination is still important," said lead report author Brendan Flannery, an epidemiologist with the CDC.

"But there are ways of treating and preventing flu that are especially important this season," he added. 

These include early treatment with antiviral drugs and preventing the spread of flu by washing hands and covering coughs, he said. 

Twenty-three percent effectiveness means that there is some benefit -- a little less flu in the vaccinated group. Flu is usually more common among unvaccinated Americans, Flannery said, "but this year there is a lot of influenza both in people who are vaccinated and in people who are unvaccinated."

The findings are published in the Jan. 16 issue of the Morbidity and Mortality Weekly Report.

As of early January, the middle of flu season, flu was widespread in 46 states, and 26 children had died from complications of the infection, CDC figures show. 

The vaccine's reduced effectiveness highlights the need to treat serious flu quickly with antiviral drugs such as Tamiflu or Relenza, the CDC said. Ideally, treatment should start within 48 hours of symptoms appearing.

Spot shortages of these drugs have been reported, and the CDC said that people may have to contact several pharmacies to fill these prescriptions. However, it anticipates enough supply overall to meet the high demand. 

In flu seasons when the vaccine is well matched to the circulating H3N2 strains, effectiveness has been between 50 and 60 percent, the CDC said. This year, however, about 70 percent of the H3N2 virus seen has been different from the H3N2 strains in the vaccine, which explains its reduced effectiveness, Flannery said.

Flu viruses change constantly, and this new H3N2 virus did not appear until after the flu strains were chosen for inclusion in the current vaccine, he explained.

Vaccine effectiveness is also related to the health of those getting vaccinated. The vaccine works best in young, healthy people, and is less effective in those 65 and older, the report noted.

This year's shot is most effective -- 26 percent -- for children 6 months old through 17 years. Older people get less benefit -- just 12 percent for those 18 to 49 years and 14 percent for those 50 and older, the CDC said.

Although the vaccine is less reliable than in some years, the CDC still recommends that everyone 6 months and older get vaccinated. Vaccination can prevent some infections and reduce severe disease that can lead to hospitalization and death, the agency said. 

Also, the vaccine protects against three or four flu viruses, some of which may circulate later this season, Flannery said. 

Dr. Marc Siegel, a professor of medicine at NYU Langone Medical Center in New York City, agreed. As other flu strains included in the vaccine emerge later in the season, he predicted the vaccine's effectiveness will rise to about 40 percent. 

Flu activity so far this season has been similar to the 2012-2013 flu season, which was classified as a "moderately severe" flu, officials say. Siegel said that season "the vaccine's effectiveness was about 40 percent, so this is even worse." 

However, he agreed it's a good idea to get a flu shot. "Twenty-three percent is better than nothing, and there is no downside to getting the vaccine," Siegel said.

Source: www.nlm.nih.gov

By ANEMONA HARTOCOLLIS

Lindsey Hallen is in the bug spray aisle at REI, the outdoor equipment emporium in SoHo, looking for exactly the right mosquito repellent to take to West Africa’s Ebola zone, when her phone rings. Three ascending tones, the personal anthem of an emergency room nurse, captured in a ringtone called “Summit.”

“Hello?” she says, pulling the phone out of her jacket pocket. Then in an aside, “I think this is them.”

Ms. Hallen listens, pacing back and forth along the aisle, as her gaunt face takes on the same wide-eyed look of concentration it assumes as when she works in the emergency room at Lenox Hill Hospital in Manhattan. Total Focus. Matter of Life and Death.

Since the latest Ebola outbreak entered public consciousness, most accounts of United States health workers have focused on the ones returning; the missionaries who were airlifted out and brought back from the brink of death, or Craig Spencer, the young doctor cured of the virus at New York City’s premier public hospital, Bellevue Hospital Center in Manhattan, while much of the city held its breath.

Now Ms. Hallen, a 31-year-old nurse with two years’ experience working with critically ill patients in this country, is going the other way, heading to West Africa to fight an epidemic that has sickened 21,000 people and killed more than 8,000.

“Why?” her friends and colleagues invariably ask when they find out what she is doing. Why would a relatively young, untested nurse want to risk putting her life in jeopardy to help save people living thousands of miles away, people sick and dying of a brutal, bleeding, contagious fever?

The question annoys her. Her reasons are instinctive, from the gut. You feel driven to do this or you don’t. The thinking only comes later.

“Why not?” she replies. “Why not me?” So the phone call shakes her. The woman on the other end of the line is a recruiter for Partners in Health, the Boston organization that is sending her to West Africa. Instead of Sierra Leone, as had been planned, the group now wants her to go to Liberia, the woman says. Ebola cases there have fallen, but they need people who can rebuild the shattered medical system, teach about controlling infection. She won’t have direct contact with patients. Yes, she can still go to Sierra Leone if she wants to, and take care of patients there. The final decision is up to her.

So the choice is this: Be an instructor, safe, teaching other people how to wear a protective suit, or be the one wearing the suit. She is given a day to decide.

Ebola officially reached American shores on Sept. 30, when Thomas Eric Duncan, a Liberian visiting family in Dallas, tested positive for the virus. Preparing for a possible onslaught, Lenox Hill Hospital set up a room within the emergency department where Ebola patients would be isolated. The staff had to be trained in wearing protective gear, the stifling, fluid-proof layers that include bootees, gloves, gowns, goggles and face shields. The more Ms. Hallen learned, the more she wanted to know. She volunteered for advanced training. She started lingering on the website of the Centers for Disease Control and Prevention. “I was looking at the case numbers and I started to become a little obsessed with everything that was going on over there, and how it was impacting us here,” she said.

She spoke of her newfound interest to her older sister, Kimberly, a real estate photographer, who sensed that this was more than a casual attraction. “She texted me saying she had volunteered to train how to handle Ebola if it came to New York City,” Kimberly recalled. “In the back of my head, I was like, ‘Oh, God, I feel like this is going to expand into her wanting to do a little bit more.’ But I kind of put it away. Maybe not.”

“She’s always been like this ever since she was little,” Kimberly Hallen said. “She was always the one who was trying to find the next fun thing to do. She was bored so easily.”

Lindsey Hallen, a slight blonde with eyes that shift from green to blue depending on the weather and her mood, grew up in suburban Cheshire, Conn., and was a communications major in college, but not a very serious one. “I was very social and that was what I cared about,” she said. After graduation, she moved to Hawaii, without knowing anyone or even having visited. “I was amazed how well everything fell into place,” she said.

She worked at an animal clinic and went to South Africa on an unpaid internship in wildlife conservation. After two years, she moved to Boston, where her sister lives, and began working at Global Vision International, the organization that had sponsored her internship. Her job sent her to South Africa, Guatemala and Costa Rica, to make sure projects were running smoothly. As a memento, she wears three bracelets on her right arm made of twisted copper and brass that she bought at street markets in South Africa. She never took them off, but she had to leave them with her sister before departing for Africa.

After three years, she wanted to grow. She thought about veterinary school, but she also wanted to travel. “Nursing came to mind as a perfect middle ground,” she said. Now, after two years in the E.R., the dread that she has done something wrong no longer wakes her at night. She can rattle off the medical script for an alcoholic with the shakes, a child with the flu or an elderly woman with a broken hip like someone reciting a Social Security number.

There has to be more to life than the three-block dash from her Upper East Side brownstone studio to the 8-a.m.-to-8-p.m. shift at Lenox Hill, and back.

The Ebola patient in Dallas died on Oct. 8, having set off a rapid chain of events. Two nurses who treated him fell ill, shaking confidence in the United States health care system. In mid-October, several New York hospitals volunteered to be Ebola treatment centers, including a sister hospital to Lenox Hill. On Oct. 23, Dr. Spencer, recently returned from Guinea, was rushed to Bellevue and tested positive. The next day, Kaci Hickox, a nurse returning from Sierra Leone through Newark Liberty International Airport, was forced into quarantine because of public officials’ fears.

Rather than being frightened, Ms. Hallen was swept away. Ebola was her 9/11, the disaster that nourished her sense of purpose.

Scrolling through the C.D.C. website, she came across a link to an application form for medical volunteers willing to go to West Africa, kind of like a universal college application online.

She recalls sending it in a few days after Ms. Hickox returned. Her first response, from Partners in Health, arrived on Halloween night. She sent back an email as she dressed for a Halloween party. She was not a sexy witch, or even a nurse. She wore a $12 zombie suit with a zipper splitting her face.

Still, she didn’t really think it would happen. And she assumed that even if she were selected, she would not be paid, and she could not afford that. But Partners in Health agreed to pay for her travel, expenses and medical insurance, as well as provide a stipend that would cover most of her lost salary for nine weeks; six weeks in West Africa and three weeks upon her return, during the disease’s incubation period. As a single person, she didn’t have to worry about disrupting anyone else’s life.

The agency also agreed to pay for her evacuation if she contracted Ebola — a further reminder of the dangers.

Her mother, Laura, cried when she heard the news. Her father, Dan, “had a million questions” but was proud of her.

“I think that she’s got the right mentality to perform in this type of environment,” Mr. Hallen said. “I guess what I would liken it to is firefighters that rush into a burning building when everyone else is running out. All I can say to that is, thank God for them. Where would we be without them?”

That mentality is not widely shared, the numbers suggest.

Since November, about 1,300 people have applied to travel to West Africa through Partners in Health, and about 360 have been hired, Sheila Davis, chief of the agency’s Ebola response, said. She said she was still looking for people with the right “humility,” but the number of applicants has declined as Ebola has moved off the front pages.

North Shore-LIJ Health System, the hospital network that includes Lenox Hill, has 54,000 employees. Ms. Hallen is only the second one to go to West Africa to treat Ebola, Joseph Moscola, the system’s chief of human resources, said. An informal survey of other New York City hospitals found few if any volunteers at most of them.

At some hospitals an internal debate rages over whether highly trained specialists should be volunteering to do menial work in African field hospitals or can make a better contribution at home, perhaps by doing Ebola research.

“Major academic institutions, you would think, would be those who would be pushing it,” Ms. Davis said. “But it’s the opposite. It’s definitely been Middle America, and California, but not the numbers you would think in Boston and New York.”

In preparation for Ms. Hallen’s trip, Partners in Health sent her a packing list. Mostly it is similar to a list for summer sleep-away camp: shampoo, toothbrush, underwear. But not entirely. She will need a headlamp, in case the electricity goes down, and some fancier clothes to wear for Embassy events. Also, styptic pencils to stanch cuts, and tampons, for nosebleeds, ominous inclusions in an environment where bodily fluids may be deadly. Ms. Hallen has scratched out the word “condoms.” She has enough contagion to worry about, she said. She trades email with other volunteers. Bring washable shoes, they say. Dried fruit, nuts and granola bars, to break the monotony of rice and beans.

She picks up her mosquito net at REI and jokes that she might use it to keep away the cockroaches in her apartment. Last night she slept with a hat on, haunted by a woman who had arrived at the emergency room with ear pain. The diagnosis: a cockroach stuck in her ear canal.

At the checkout counter, the brooding, longhaired salesman examines her basket and asks where she is going. “Sierra Leone or Liberia,” she replies.

“You should read this book,” he says, and on a scrap of paper writes the name Peter Piot, author of a memoir about the discovery of Ebola and AIDS.

The next night, she writes an email to the recruiter from Partners in Health. Deletes it. Writes it again. Presses “send” at 11:42 p.m.

At 10 a.m. Saturday, she was scheduled to fly to Sierra Leone, to care for people who are sick and dying of Ebola.

Source: www.nytimes.com

By LIZ NEPORENT

Just like Luke Skywalker, 7-year-old Liam Porter of Augusta Georgia has been given a brand new arm.

Porter, who was born without the lower part of his left arm, was recently surprised with a prosthetic arm modeled after the Imperial Clone Troopers in Star Wars.

“Liam wants it made clear it is a Clone Trooper not a Storm Trooper arm,” said his mother Ryan Porter.

In the Star Wars movies, Clone Troopers are the good guys and Storm Troopers are evil.

Porter used to have a traditional prosthesis but it was boring and clunky, John Peterson, the limb’s designer said. The boy thinks the new arm is not only “extremely awesome,” it’s lighter and easier to move. It has a clamp on it and a rail system to slide different attachments on and off. As he grows, the arm can be adjusted.

Porter’s space-age appendage was a arranged by E-nable, a global network of volunteers who 3D print mechanical hands and arms for kids in need then give them away for free.

Jon Schull, E-nable’s founder, is also a research scientist at the Rochester Institute of Technology. He said the group pairs each child with a “maker” who takes a basic prosthetic design and customizes it.

Peterson went above and beyond, Schull noted.

“I believe this is the first Clone Trooper arm we’ve done,” Schull said.

The arm took about three months to make and cost about $300, according to Peterson. The price tag for a typical prosthetic arm is upwards of $9,000, Schull pointed out.

In its first year, E-nable has given away more than 700 arms and hands. Members of 501st Georgia Garrison, a group of people who dress up as Storm (and Clone) Troopers, presented Porter with his at a surprise ceremony held at a local movie theater.

“He was actually speechless, which for him is a rarity,” his mom said. “It’s amazing John donated his time and own money to make this happen, just to see the joy on my son’s face.”

Source: http://abcnews.go.com

By Cynthia Howard RN, CNC, Phd

Finding the right nursing job includes finding a manager that will help you grow, develop, and support your career goals.

There is a saying that people leave their managers and not their jobs and to have success in your career may mean you want to circulate your resume in order to find the best fit for you. This means you have to know what you want and need in the area of support.

Here are 10 warning signs you may be working with the wrong manager:

1. You never hear from your manager prior to your performance reviews. Over 75% of performance problems can be improved with proper feedback and less than 33% of the time, feedback is provided.
    
2. You have no idea what they want.  This can be worse than not having feedback at all. When a manager says, “I do not like how you did that,” you really have no way of knowing what they really mean. Make sure to ask for clarification. Review your job description and ask for your manager to specify what parts of your job responsibilities are most important to them. It could be they are focused on patient safety and you have an interest in health literacy. Knowing what they want gives you the advantage of focusing your efforts for the greatest gain.
    
3. It is their way or the highway.  This is a problem for many nurses. Job satisfaction comes with autonomy and the opportunity to solve your own problems as they show up on the job. When a manager consistently tells you what and how to do something, employees quickly turn off their own creativity; more than likely, with an increase in mistakes.
   
   A nurse who is practicing for 7 years shared a story about his experience on a new unit. His Clinical Specialist was a micro-manager. She told him to give this medication immediately because of incoming admissions. She had poured the med. This went against his better judgment but because he knew she would have a fit, he gave it, to the wrong patient. She was extremely apologetic however the “error” was on him. Do not compromise your judgment for the sake of status quo.
    
4. Your manager wants you to figure it out.  The opposite of micro-managing is to not manage at all and letting everyone figure it out for themselves. This happens quite a bit leaving the power position to go to the most domineering individuals on the unit. Everyone needs to know the manager is in charge and when needed will make those tough decisions.
    
5. You could not recognize them if your life depended on it.  If your manager hides behind email or a closed door, having a relationship with your manager will be impossible. Communication and trust is the foundation of a great working relationship.  
   
   Suggestion for managers: Time is an important commodity and getting around to all your staff can be time consuming. Why not use technology and set up a short video. Most iPhones take excellent video. Take 2-3 minutes every week and share what is going on. You may also want to share something personal about yourself; if you just started juicing, kickboxing, celebrated an anniversary or a milestone with your children. Interview them, show images along your morning run, and share something of yourself in order to make the connection with your staff.
   
   Suggestion for staff: Make a short video on your unit of a new initiative, gratitude board in the break room, more efficient way to give report, a snippet of rounds, and just a friendly hello from everyone on the unit. You may even want to say thanks and express appreciation; managers are people too!
    
6. The way out the door is faster than up. If you have a manager that makes any attempt for you to advance your skills difficult, it will be hard to boost your resume. Managers can feel threatened by qualified staff members who want to move up the ladder and may indirectly thwart your efforts to move forward. This is really short sighted on the manager’s part because any manager that turns our qualified leaders actually looks really good to their higher ups given the ongoing need for good talent in any organization.
    
7. Lack of training.  Being able to do a job well requires the right training. Often it takes the manager to assess the need for training based on performance and outcomes. This relates to the lack of feedback. While every employee really should do their own assessment of what they need to do well and then make the request of their manager, the manager should also be on the lookout for staff that need training and set up opportunities to make this happen.
    
8. When the manager has obvious “favorites.”  Everyone has preferences in personality style, but when the manager consistently selects one particular individual for all the initiatives, opportunities for advancement, or other assignments that provide variety, the manager is sending a message to others they do not care about your skills or your future.
    
9. When your manager routinely says, “I’ll think about it.”  Obviously considering all sides of the problem/ situation is important however some managers hide behind this and never make a decision about what is the ideal way to go.  Quickly, this can be frustrating if you are looking for a course of action to solve a problem.
    
10. When your manager over reacts or criticizes you in front of others.  This is a toxic behavior and is an indication you want to find a new place to work. Quickly this will diminish your self-esteem, leading to resentment and stagnation.
    
    Knowing what you want in the way of workplace is key and will help you avoid a poor manager. What type of opportunities are you looking for in the workplace? What are your career goals? Evaluate the workplace, ask questions, find out the management style, review a performance appraisal, ask about turnover, and see if you can build a relationship with your new manager.  

Enjoy the opportunity to find a place that truly supports and honors you! 

Source: www.nursetogether.com

By Sanjay Gupta

So, in no particular order, here's my take on the nine big health stories to watch for, and the questions they will likely raise, in 2015.

Doctor shortage. There aren't nearly enough of us to care for the U.S. population. By some estimates, the country is already short of tens of thousands of doctors, a problem that will only get worse as the demand for care increases with our aging population. That could mean longer wait times for you when you need to make an appointment. But that also means policy makers will have to consider questions like: Is there a way to increase the number of residency training slots? Are there other health care professionals who can reasonably fill in the gaps? Will the nation's quality of care go down? How can the country avoid a situation where only the wealthy will be able to afford quality care? 

Hospital errors and infections. Hospital mistakes and infections are still one of the leading causes of preventable death (indeed, some studies suggest "hospital-acquired conditions" kill more people than car accidents or diabetes). 

True, a recent study showed the rate did get better this year, saving tens of thousands of lives. But what else can hospitals do to prevent these mistakes and infections? Can technology like e-prescriptions and electronic health records prevent problems that most often occur: the mistakes caregivers make with a patient's drugs? 

Antibiotic resistance. It has been called public health's "ticking time bomb."The World Health Organization calls antibiotic resistant infections one of the biggest threats to global health today. Each year, at least 2 million peoplebecome infected with bacteria that are resistant to antibiotics, and at least 23,000 people die each year. Most of these deaths happen in health care settings and in nursing homes. How can we respond? Well, research teams around the world have already started searching for the next generation of infection-fighting drugs. But it remains to be seen if time will run out, sending us back to the beginning: a time before antibiotics, where even a cut that becomes infected could kill you. 

More do-it-yourself health care: apps and technology. Technology has made do-it-yourself patient care much easier. This goes beyond just a patient's ability to look up their symptoms online. There are apps to help with autism, apps that can simulate a check-up, apps that can monitor conditions. Wearables can motivate you to walk more or sleep more or check a diabetic's glucose level. But how does all this helping yourself make your health care better? How much is too much? And what does this mean for your privacy? After all, the health care industry accounted for 43% of all major data breaches in 2013. Meanwhile, although 93% of health care data requires protection by law, some surveys suggest only 57% of it is "somewhat protected." What could this mean for your privacy and personal information if security doesn't get better? 

Food deserts. While not everyone agrees with the term food desert, the USDA still estimates 23.5 million people live in these urban neighborhoods and rural towns with limited access to fresh, affordable, healthy food. Without grocery stores in these areas, residents often have to rely on fast food and convenience stores that don't stock fresh produce. It takes a real toll on their health. Families who live in these areas struggle more with obesity and chronic conditions, and they even die sooner than people who live in neighborhoods with easy access to healthy food. More farmers markets are now accepting food stamps and many nonprofits have stepped in to try to bring community gardens and healthy food trucks to these areas, but so far it's not enough. Will cities offer incentives to grocery store chains to relocate to these neighborhoods?  How else can this system be helped? 

Caregivers for the aging population. We are heading into a kind of caregiver crisis. The number of people 65 years and older is expected to rise 101%between 2000 and 2030, yet the number of family members who can provide care for these older adults is only expected to rise 25%. This raises a series of related questions, not least who is going to step up to fill the gaps? Will cities that don't traditionally have strong public transportation systems add to their routes? Will developers create more mixed-use buildings to make shopping and socializing easier to access? Could the government create a kind of caregiver corps that could check in on the isolated elderly? Who will pay for this expensive kind of safety net? 

The cost of Alzheimer's. Currently about 5.2 million Americans have Alzheimer's. That number is expected to double every 20 years. With a cure some way off, what can be done to ease the emotional and financial burden on families and communities affected by the disease? The Alzheimer's Association predicts that by 2050, U.S. costs for care will total $1.2 trillion, making it the most expensive condition in the nation. How will we be able to afford the costs of caring for this population? What can the country do to achieve the goal the White House set for preventing and effectively treating Alzheimer's by 2025?

Marijuana. With the growing acceptance of weed, we can expect that more laws will change to allow medical and recreational use of marijuana. How will the rest of the laws in this country adjust? For instance, Washington state is coming up with a Breathalyzer-type device to check if drivers are high. But it will be interesting to see how readily available these devices are going to be. Will legalization improve the scientific understanding of the long-term consequences of the drug? What other uses could this drug have to help those who may need pain relief most?

Missing work-life balance. Americans spend more time on the job than most other developed countries. We don't get as much vacation, we don't take what vacation we have, and we are prone to working nights and weekends. This stress has a negative impact on Americans' health. What are companies doing to help? What technology can change this phenomenon? Will millennials who say work-life balance is a bigger priority than other generations rub off on the rest of us? What can we personally do to find a better balance? 

We may not be able to answer all these questions in 2015, but we sure will try. And the health team and I look forward to exploring these issues with you in the coming New Year.

Source: www.cnn.com